title: Problem solving for breast health care delivery in low and middle resource countries (LMCs): consensus statement from the Breast Health Global Initiative.
abstract: International collaborations like the Breast Health Global Initiative (BHGI) can help low and middle income countries (LMCs) to establish or improve breast cancer control programs by providing evidence-based, resource-stratified guidelines for the management and control of breast cancer. The Problem Solving Working Group of the BHGI 2010 Global Summit met to develop a consensus statement on problem-solving strategies addressing breast cancer in LMCs. To better assess breast cancer burden in poorly studied populations, countries require accurate statistics regarding breast cancer incidence and mortality. To better identify health care system strengths and weaknesses, countries require reasonable indicators of true health system quality and capacity. Using qualitative and quantitative research methods, countries should formulate cancer control strategies to identify both system inefficiencies and patient barriers. Patient navigation programs linked to public advocacy efforts feed and strengthen functional early detection and treatment programs. Cost-effectiveness research and implementation science are tools that can guide and expand successful pilot programs.
authors.affiliation: Office of International Affairs, National Cancer Institute, National Institute of Health, Bethesda, MD, USA.
authors.forename: Joe B
authors.initials: JB
authors.lastname: Harford
authors.forename: Isabel V
authors.initials: IV
authors.lastname: Otero
authors.forename: Benjamin O
authors.initials: BO
authors.lastname: Anderson
authors.forename: Eduardo
authors.initials: E
authors.lastname: Cazap
authors.forename: William J
authors.initials: WJ
authors.lastname: Gradishar
authors.forename: Julie R
authors.initials: JR
authors.lastname: Gralow
authors.forename: Gabrielle M
authors.initials: GM
authors.lastname: Kane
authors.forename: Laurens M
authors.initials: LM
authors.lastname: Niëns
authors.forename: Peggy L
authors.initials: PL
authors.lastname: Porter
authors.forename: Anne V
authors.initials: AV
authors.lastname: Reeler
authors.forename: Paula T
authors.initials: PT
authors.lastname: Rieger
authors.forename: Lillie D
authors.initials: LD
authors.lastname: Shockney
authors.forename: Lawrence N
authors.initials: LN
authors.lastname: Shulman
authors.forename: Tanya
authors.initials: T
authors.lastname: Soldak
authors.forename: David B
authors.initials: DB
authors.lastname: Thomas
authors.forename: Beti
authors.initials: B
authors.lastname: Thompson
authors.forename: David P
authors.initials: DP
authors.lastname: Winchester
authors.forename: Sten G
authors.initials: SG
authors.lastname: Zelle
authors.forename: Rajendra A
authors.initials: RA
authors.lastname: Badwe
mesh_terms: D001943:Breast Neoplasms; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000592:standards; D003906:Developing Countries; D005260:Female; D006284:Health Plan Implementation; D006287:Health Planning Guidelines; D006801:Humans; D033183:Interdisciplinary Communication; D007391:International Cooperation; D017063:Outcome Assessment, Health Care; D010344:Patient Advocacy; D011340:Problem Solving; D036301:Qualitative Research; D012042:Registries; D000078329:Workforce